The effects of treatment on the direct costs of diabetes

Treatment of diabetic complications consumes health care resources. Intensi ve therapy was shown by the Diabetes Control and Complications Trial (DCCT) to avert complications. Economic analyses and models have been used to eva luate the cost-effectiveness of intensive therapy for people with type 1 an d type 2 diabetes. An economic analysis of the DCCT estimated the cost of i ntensive therapy to be two to three times greater than that of conventional therapy In contrast, an economic model predicts that intensive therapy as compared with conventional therapy, could reduce blindness from 34 to 20% o r by 41%, end-stage renal disease from 24 to 7% or by 71%, and lower-extrem ity amputations from 7 to 4% or by 43%. Although intensive therapy is more expensive, when the costs of complications are factored in, it becomes cost -effective for treatment of type 1 diabetes. Similarly, a model to evaluate the cost-effectiveness of intensive therapy for people with type 2 diabete s found that the lifetime costs of general and diabetes-related medical car e would be approximately two times greater However, the reduction in lifeti me costs of complications, which would produce substantial reductions in co sts of treatment, largely offsets the difference. Intensive therapy for typ e 1 and type 2 diabetes may be more expensive than conventional therapy, bu t from an economic perspective, it is comparable in cost to pharmacological therapies for people with hypertension and hypercholesterolemia. From a he alth system viewpoint, intensive therapy represents a fruitful long-term fi nancial investment.